Hello. I am concerned about the recovery with progressive sutures (quilting method) due to the tissue being attached to the muscle and not being able to stand straight for a longer period of time. The doctor is placing two drains as well, is this needed? How long will it take to stand straight with progressive sutures? Also, can I request that the muscle repair not be as tight on the top section of the muscles, or do doctors just tighten the muscles as tight as possible throughout? Thanks.
Is It More Challenging to Stand Straight Sooner with Progressive Sutures or Quilting Method?
Doctor Answers 4
Quilting sutures and abdominoplasty
Quilting sutures are an acceptable method of closing up some of the space that is created when doing an abdominoplasty. It does reduce the incidence of post operative fluid collection. I do not think that placing quilting sutures will in any shape impede with your usual post abdominoplasty position, and I also do not feel that it improves your recovery. I also think that drains are very much necessary in almost all types of abdominoplasty. As far as muscle repair is concerned it really needs to be done where it is needed. This is something that is very clear intraoperatively.
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Quilting sutures and recovery.
Quilting sutures simply reduce the risks of postoperative seromas by limiting the sheering that would normally occur between the abdominal skin and the underlying abdominal wall. As for impacting recovery and the ability to stand up straight, this would be minimal. I recommend these sutures in most of my abdominoplasties because they lead to a quicker removal of the drains.
Quilting sutures with abdominoplasty
In my opinion, the use of quilting sutures speeds up recovery and greatly reduces the chance of a postoperative fluid collection (seroma) and also speeds up drain removal. I've been using quilting sutures so about 3 years now and I cannot imagine doing abdominoplasty with them. They have helped so much with postoperative recovery and the eventual result.
I do not think they have any effect on how soon a patient can stand straight. They do restrict twisting which is a good thing. Early twisting after surgery can stir up bleeding or fluid collections. Also, if you cannot twist, there are a few things you cannot do that you should not do for a few weeks after surgery - take clothes from your front load washer and put them in the dryer, rake leaves, sweep, wash windows, scrub the floor, make the bed or take stuff out of the oven. SWEET.
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Of course you should voice your concerns to the doctor. But if the muscles are not tightened equally throughout the abdomen, and less at the top, you will likely have a bulge at the top of the abdomen.
I have not seen my patients stay bent over any longer since I started using the progressive tension closure (same as quilting) but their overall recovery is much faster.
I use only one drain and my associate uses four. Go figure!